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👤

Employee & Company Details

Basic information about the home worker

Under the Health and Safety at Work Act 1974, employers have the same duty of care for home workers as for office-based staff.
📍

Home Address & Assessment Dates

Location and scheduling information

📅

Working Pattern

How does the employee divide their time?

🏠
Full-time from home
🏠📍
Hybrid - mostly home
📍🏠
Hybrid - mostly office
📍
Occasional home working
🏠

Workspace Setup

Details about the home workspace

Type of Workspace?

🚪
Dedicated room
🛋️
Shared room
🍽️
Kitchen/dining table
🌡️

Environmental Conditions

Lighting, temperature, and ventilation

Adequate space for equipment?

✅
Yes
❌
No

Suitable lighting?

☀️💡
Natural + artificial
💡
Artificial only
⚠️
Inadequate

Temperature controllable?

✅
Yes
❌
No

Adequate ventilation?

✅
Yes
❌
No

Workspace tidy and safe?

✅
Yes
⚠️
No
💻

Display Screen Equipment

Computer setup and ergonomics

Separate keyboard provided?

⌨️
Yes
❌
No

Separate mouse provided?

🖱️
Yes
❌
No

Monitor at appropriate height?

✅
Yes
⚠️
No

Regular breaks taken?

✅
Yes
⚠️
No

Screen free from glare?

✅
Yes
⚠️
No

Eye test offered?

✅
Yes
❌
No
⏳
Not yet
🪑

Seating & Ergonomics

Chair and posture assessment

Chair adjustable for height?

✅
Yes
❌
No

Chair provides back support?

✅
Yes
⚠️
No

Feet flat on floor or footrest?

✅
Yes
⚠️
No
⚡

Electrical & Fire Safety

Safety of equipment and premises

Electrical equipment in good condition?

✅
Yes
⚠️
No

Sockets not overloaded?

✅
Yes
⚠️
No

Trailing cables managed safely?

✅
Yes
⚠️
No

PAT testing arranged?

✅
Yes
❌
No
➖
Not applicable

RCD protection in place?

✅
Yes
❌
No
❓
Unsure

Smoke alarm fitted and working?

🔔
Yes
❌
No

Clear escape route from workspace?

✅
Yes
⚠️
No

Fire extinguisher accessible?

🧯
Yes
❌
No

Exit plan known?

✅
Yes
❌
No
💚

Mental Health & Wellbeing

Support and work-life balance

Regular contact with manager?

📞
Daily
📅
Several times/week
📆
Weekly

Regular contact with colleagues?

👥
Daily
📅
Several times/week
📆
Weekly

Able to maintain work-life boundaries?

✅
Yes
⚠️
Sometimes
❌
No

Workload manageable?

✅
Yes
⚠️
Sometimes
❌
No

Feelings of isolation?

✅
No
⚠️
Occasionally
❌
Frequently

Access to employee assistance?

✅
Yes
❌
No
❓
Unsure
🔒

Security & Data Protection

Data safety and confidentiality

Work on secure/encrypted device?

🔐
Yes
⚠️
No

VPN used for company systems?

🔐
Yes
⚠️
No
❌
Not required

Screen not visible to others?

✅
Yes
⚠️
Sometimes
❌
No

Home Wi-Fi password protected?

✅
Yes
⚠️
No

Confidential documents stored securely?

✅
Yes
❌
No
➖
Not applicable
⚠️

Risk Evaluation & Actions

Assessment summary and required actions

Risk adequately controlled?

✅
Yes
❌
No
✍️

Sign-Off and Approval

Final confirmation and approval dates

Arrangements satisfactory?

✅
Yes
❌
No
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WORKING FROM HOME RISK ASSESSMENT

Health and Safety at Work etc. Act 1974 | Management of Health and Safety at Work Regulations 1999

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